The prevalence and impact of symptom clusters on adult oncology patients is a new area in symptom management research. However, only one pilot study was found in the literature that attempted to evaluate the occurrence of symptom clusters in PEDIATRIC oncology patients. Therefore, the specific aims of this pilot study, in a sample of pediatric oncology patients, ages 10 to 18, who are undergoing chemotherapy (CTX) are to: (1) identify the prevalence, severity, frequency, and distress of single symptoms that occur acutely (i.e., 1 week post treatment, at nadir (i.e., 2 weeks post treatment), and during recovery (i.e., 3 weeks post treatment); (2) identify the number and types of symptom clusters that occur acutely (i.e., 1 week post treatment, at nadir (i.e., 2 weeks post treatment), and during recovery (i.e., 3 weeks post treatment); (3) to determine if the number and types of symptom clusters change over the course of one cycle of CTX; and (4) to determine, at each time point, the association between the number of symptoms and symptom cluster scores identified in the analyses for Aims 1 and 2 with children s reported QOL scores. Children (n=110) who are about to undergo at least their second cycle of intensive CTX will be recruited from the pediatric oncology clinics at two university medical centers. Following parental consent and child assent, children (aged 10 to 18) will be asked to complete the Memorial Symptom Assessment Scale 10-18 and generic and disease specific quality of life inventories. A total of three assessments will be completed over the course of one cycle of CTX. Data analyses will determine the frequency, severity and distress associated with single and multiple symptoms as well as the number and types of symptom clusters that occur in children who receive CTX for the treatment of cancer. Findings from this study will be used to design intervention studies for single and multiple symptoms in pediatric oncology patients. [unreadable] [unreadable] Recent findings suggest that adult oncology patients experience multiple symptoms simultaneously and that these symptoms may occur in groups that are called symptom clusters. Little information is available on the co- occurrence of multiple symptoms or symptom clusters in pediatric oncology patients. The research study will provide new information on multiple symptoms and symptom clusters in children who receive chemotherapy for cancer. [unreadable] [unreadable] [unreadable]